Pain is a central feature in small fiber neuropathy (SFN), with only moderate effects of pharmacologic treatment. The evaluation of the efficacy of therapies on pain has been driven by static measures, and a circadian cycle has been suggested. The aim of this study is to evaluate the pain dynamics in SFN. A total of 165 patients completed a standardized pain diary 4 times per week over a 4-week period. Patients used the 11-point numeric rating scale for average diurnal, nocturnal, and maximum pain, taking into account the circumstances in which pain emerged most. Medication used, SFN-related complaints, sleep quality, and anatomic location of pain were also assessed. Neuropathic pain showed a length-dependent pattern. For pain intensity, marginal higher pain scores at night than during the day were shown, likely not clinically meaningful, with stable lower pain intensities in weekends compared with weekdays. The average pain intensity was stable during the 4-week period. Maximum pain was experienced mainly at rest and during sleep. Besides, pain intensity at night showed an inverse relationship with quality of sleep. In conclusion, for trials in SFN it is justified to use pain scores from any time of the day during short measurement periods. PERSPECTIVE: This article presents for the first time the pain dynamics of SFN. The effect of pharmacologic treatment in SFN is often disappointing, partly owing to insufficient trial designs. The results of this study have added value in the development of new proper clinical trials in SFN.
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http://dx.doi.org/10.1016/j.jpain.2018.11.009 | DOI Listing |
Paediatr Drugs
January 2025
Institute of Clinical Pharmacology, Peking University First Hospital, Beijing, China.
Background: This study aimed to provide a comprehensive review of adverse events (AEs) associated with factor Xa (FXa) inhibitors in pediatric patients.
Methods: We searched PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and the European Union Clinical Trials Register for English-language records from the establishment of the database up to October 17, 2023.
Indian J Gastroenterol
January 2025
Department of Gastroenterology, Christian Medical College, Vellore, 632 517, India.
Background: Groove pancreatitis (GP) is a form of pancreatitis that affects the pancreaticoduodenal groove area, which lies between the head of the pancreas, the second part of the duodenum and the distal bile duct, presenting as abdominal pain and gastric outlet obstruction. In this study, we present the clinical and radiological characteristics of individuals diagnosed with groove pancreatitis at our center and discuss the use of a conservative treatment approach in managing GP.
Methods: The data of patients with groove pancreatitis treated at our center between January 2012 and December 2021 was analyzed.
Dig Dis Sci
January 2025
Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang, 110000, Liaoning Province, China.
Dig Dis Sci
January 2025
Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
JA Clin Rep
January 2025
Department of Anesthesiology and Pain Medicine, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
Background: Cold agglutinin disease (CAD) is an autoimmune hemolytic anemia that induces blood coagulation and hemolysis upon exposure to cold temperatures. Strict temperature control is essential to mitigate these effects, especially during surgical procedures where hypothermia is possible.
Case Presentation: A 57-year-old male, 165 cm and 72 kg, diagnosed with CAD, underwent cerebral vascular anastomosis.
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